“Having commissioners with a local understanding can be more effective” than “imposing” nationally-commissioned NHS services on local populations,” Professor Jonathan Benger told C+D after his session at a Westminster Health Forum on integrating urgent and emergency care last week (November 16).

Certain NHS services – such as those tackling “minor illnesses” or “common conditions” – may “not necessarily suit…some pharmacy communities,” he said.

“What pharmacists can and are able to do may be different in one part of the country to another part,” he added.

Professor Benger was responding to a question from C+D, on whether a national scheme to direct patients with certain ailments to pharmacies would work across England.

While there should be a “national direction for travel”, NHS England's schemes should be “flexible” and “tailored” to local population needs, which can be “very different in London than in a rural community”, he suggested.

Professor Benger's comments come less than a month after pharmacy minister Steve Brine said "things have moved on", when asked how the government and NHS England plan to "buck the trend" of local minor ailments schemes being decommissioned by clinical commissioning groups.

However, Professor Benger also stressed that pharmacists have an important role to play as part of the urgent care system, “in terms of supporting patients with minor ailments”.

Challenged by long-term conditions

“Much of the urgent and emergency care system is challenged by long-term conditions,” Professor Benger added.

If patients feel “a little bit unwell over the winter period”, they could “follow advice from a pharmacist” and “prevent [health] deterioration”.

However, “by the time a patient visits a pharmacy” it is often “too late” and they have to be referred to a GP, he said.

NHS 111 pharmacy programme advisor and Yorkshire Ambulance Service NHS trust pharmacist Usha Kaushal also told C+D at the event that pharmacists can be “very cost effective in NHS 111”.

Ms Kaushal explained that pharmacists are “ideally trained” to handle calls such as “toxic ingestions”.

“The types of calls we answer are specifically pharmacy calls, such as emergency contraception and repeat prescriptions,” she added.

Urgent supply pilot extended

In October 2016, the Department of Health launched the Pharmacy Urgent Care pilot programme to allow patients who call NHS 111 for urgent repeat medication to be directed straight to a community pharmacy, instead of an out-of-hours GP surgery.

The pilot – scheduled to be rolled out in stages across England until March 2018 – will now be extended by six months “to allow a proper evaluation of the service to be completed”, the Pharmaceutical Services Negotiating Committee confirmed last week (November 19).